Individual provider Active NPI

Richard Gyles, DDS

  • Pediatric Dentistry
  • Tampa, FL
National Provider Identifier
1942211180
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18568 Issued in FL
Practice address
7728 Palm River Road
Tampa, FL 33619
Phone
(813) 630-3635
Fax
(813) 620-1614
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 053006 NY
Pediatric Dentistry 1223P0221X 18568 FL Primary

Addresses

Primary practice location

7728 Palm River Road
Tampa, FL 33619

Mailing address

13110 Elk Mountain Dr
Riverview, FL 33579-7182
Phone (813) 349-7568

Other identifiers 1

IdentifierTypeStateIssuer
009956300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160524000629 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3274822770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18568FLMDPastoral Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1942211180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 ELK MOUNTAIN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797182",
            "telephone_number": "813-349-7568",
            "fax_number": "813-349-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7728 PALM RIVER ROAD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33619",
            "telephone_number": "813-630-3635",
            "fax_number": "813-620-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYLES",
        "first_name": "RICHARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053006",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "18568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009956300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.